A scientific look at opioid addiction

Doneen Durling

Friday

Jan 6, 2017 at 9:26 AM

ASHBURNHAM — Opioid addiction has left thousands of casualties in its tracks as it tears through cities and small towns throughout the United States.

ASHBURNHAM — Opioid addiction has left thousands of casualties in its tracks as it tears through cities and small towns throughout the United States. If people are waging a battle, it is best that those in the fight understand the enemy.

The Stevens Memorial Library Speaker Series on Wednesday brought in two doctors who presented information to answer the question: “What is the Opioid Epidemic?”

“Part of our duty was to take care of patients in detox and rehab,” said Dr. Thomas Bennett, a Franklin Pierce College who practiced internal medicine in Lancaster, Penn­sylvania, for 10 years. “We took care of those withdrawing from heroin, alcohol and cocaine.”

Bennett said there is an accelerated rate of heroin and opioid abuse going on in the country right now.

Dr. Leila Jabbour is also a professor at Franklin Pierce University. Her background is primarily re­search.

“I am very much into the molecular biology aspect of several neurodegenerative diseases. I always was interested in drug addiction. We have that problem in our family, so it was personal.”

Jabbour said that when it came time to start a research project on her own, she decided to work on finding out what creates addiction.

Bennett explained that the medical community in the 1960s only had to deal with heroin and opium addiction. Now just vicodeine has over 344 different names. The medications have great analgesic effects, so there are great clinical uses, but from his own recent studies, Bennett has found that opioids do not help with chronic neuropathic pain.

“And yet we prescribe them,” said Bennett.

Starting with the poppy, extracted opium can be converted to morphine, and then converted to heroin, increasing the strength, thus increasing the abuse potential.Bennett said that people need to understand that addiction is not a failure of the person — it is a medical condition.

“Until everyone is on the same page with that, we are not going to do very well treating it,” he warned. “This needs to be recognized as a mental health disorder.”

Bennett described the intense pain and sickness experienced in withdrawal and said that anyone going back to using after going through withdrawal is “worrisome” to him. He said that 70 to 90 percent of addicts return to using, and the rate of women becoming addicted is rising. Babies are caught in the cycle of addiction and are being born in withdrawal.

Jabbour gave a perspective of what is happening in the brain of an addict. She said cells in the brain called neurons communicate with each other through electrical stimulus. There are molecules that transfer the stimulus between the two communicating cells. One such molecule, or neurotransmitter, is dopamine, or the pleasure transmitter. Then there is gaba.

“Gaba is like the parent setting a curfew,” said Jabbour.

When dopamine is released for pleasure, gaba is released by the “parent neuron” instilling a curfew on the release of dopamine, so the cell is happy and everything is good. “This is really important to the story, because this is where morphine is going to bind and really change the whole chemistry.”

Jabbour said that when heroin breaks down to morphine, the morphine binds on the parent neuron and inhibits the activity of the parent so there is no hold on how much dopamine is produced.

“That’s the euphoria,” said Jabbour.

Pain receptors are blocked, and the morphine binds to the part of the brain that controls breathing.“It’s a very powerful molecular binding. It hijacks your memory, it hijacks your decision making. It’s really physical,” said Jabbour. Bennett said there were 470 overdose deaths in New Hampshire this year. In 2013, there were 179. “This is really running forward at a great rate.”Bennett said that when he graduated from medical school in 1991, he was told that pain needed to be treated very aggressively. “Patients should not have to deal with pain at all. If they have any residual pain, you increase the amount of opioids they are getting, and you make that pain go away. Good intentions — collateral damage.”Bennett noted that addiction happens sometimes when a physician notes the patient has become addicted to the opioids provided and the patient is cut off from the prescription. Many find their way to heroin. That heroin is sometime laced with the chemical that mimics it but is much stronger and highly addictive called fentanyl. He said sometimes a dealer will measure out 10 packets of heroin and lace one with fentanyl. The dealer understands there will likely be an overdose resulting in possible death, but addicts will purchase from the dealer thinking his heroin is more powerful. Bennett said that from 1999 to 2016, physicians have increased prescriptions for opioids by 400 percent. “We don’t have decreased amounts of pain. This doesn’t work.” Librarian Emily Donnelly said that there would be three more Current Events Speaker Series presentations. On Feb. 8, Dr. Thomas Montagno will present “What Are GMOs?” In March the Ashburnham Police Department will help to clarify the Second Amendment and gun laws in Massachusetts. In April one more presentation has been added, which will be on climate change.

Never miss a story

Choose the plan that's right for you.
Digital access or digital and print delivery.